Evaluating the Impact of Volunteer and Facility Provided Doula Support in the Intrapartum Period on Maternal, Neonatal, and Psychosocial Outcomes in the Hospital Setting
Background/Purpose: The unacceptably high maternal mortality rate in the United States has demanded a call to action for evaluation and implementation of efforts to improve both maternal and neonatal outcomes. Low-resource and low-socioeconomic populations are at a higher risk of experiencing adverse birth outcomes. Doulas have continuously been recognized as key tools in improving outcomes, but not all birthing persons have access to them. The positive impact of continuous labor support in improving outcomes is recognized by the American College of Obstetricians, American College of Nurse-Midwives, the Society for Maternal-Fetal Medicine, and the March of Dimes. The purpose of this review is to critically assess the impact of continuous intrapartum support given by volunteer or facility program doulas on maternal, neonatal, and psychosocial outcomes in the hospital setting. Methods: The PRISMA model was used to search for applicable evidence across five research databases. Exclusion and inclusion criteria were applied to search for and obtain 20 studies in relation to the research topic. The studies were then critiqued utilizing John Hopkins Evidence Appraisal Tool and were categorized as level I, level II, or level III followed by either high (A), good (B), or low (C) quality evidence. A literature matrix was then used to organize the data to be synthesized for this review. Results/Findings: Intrapartum support given by a volunteer or facility provided doula improved many outcomes researched. Maternal outcomes that demonstrated an improvement included cesarean section rates, breastfeeding initiation, and pharmaceutical pain management. Decreased preterm birth rates and increased birth weights were also identified when doula support was provided to the neonate’s mother. Birth experiences were also consistently reported as positive by participants.